Skip to main content

Advertisement

SpringerLink
Log in

Five-year results of cervical disc prostheses in the SWISSspine registry

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Background

The Swiss Federal Office of Public Health demanded a nationwide HTA-registry for cervical total disc arthroplasty (TDA), to decide about its reimbursement. The goal of the SWISSspine registry is to generate evidence about the safety and efficiency of cervical TDA.

Materials and methods

Three hundred thirty-two cases treated between 3.2005 and 6.2006 who were eligible for 5 years follow-ups were included in the study. Follow-up rates for 3–6 months, 1, 2 and 5 years were 84.6, 74.4, 50.6 and 64.8 %, respectively. Outcome measures were neck and arm pain, medication, quality of life, intraoperative and postoperative complication and revision rates. In addition, segmental mobility, ossification, adjacent and distant segment degeneration were analyzed at the 5-year follow-up.

Results

There was significant, clinically relevant and lasting reduction of neck (preop/postop 60/21 VAS points) and arm pain (preop/postop VAS 67/17) and a consequently decreased analgesics consumption and quality of life improvement (preop/postop 0.39/0.82 EQ-5D points) until the 5-year follow-up. The rates for intraoperative and early postoperative complications were 0.6 and 7.2 %, respectively. In 0.6 % an early and in 3.9 % a late revision surgery was performed. At the 5-year follow-up, the average range of motion of the mobile segments (88.2 %) was 10.2°. In 40.7 % of the patients osteophytes at least potentially affecting range of motion were seen.

Conclusions

Cervical TDA appeared as safe and efficient in long-term pain alleviation, consequent reduction of pain killer consumption and in improvement of quality of life. The improvement is stable over the 5 years postoperative period. The vast majority of treated segments remained mobile after 5 years, although 40.7 % of patients showed osteophytes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Resnick DK, Watters WC (2007) Lumbar disc arthroplasty: a critical review. Clin Neurosurg 54:83–87

    PubMed  Google Scholar 

  2. Singh K, Vaccaro AR, Albert TJ (2004) Assessing the potential impact of total disc arthroplasty on surgeon practice patterns in North America. Spine J 4:195S–201S. doi:10.1016/j.spinee.2004.07.009

    Article  PubMed  Google Scholar 

  3. Richards O, Choi D, Timothy J (2012) Cervical arthroplasty: the beginning, the middle, the end? Br J Neurosurg 26:2–6. doi:10(3109/02688697).2011.595846

    Article  PubMed  CAS  Google Scholar 

  4. Denaro V, Papalia R, Denaro L, Di Martino A, Maffulli N (2009) Cervical spinal disc replacement. J Bone Jt Surg Br 91:713–719. doi:10.1302/0301-620X.91B6.22025

    CAS  Google Scholar 

  5. Goffin J, Van Calenbergh F, van Loon J, Casey A, Kehr P, Liebig K, Lind B, Logroscino C, Sgrambiglia R, Pointillart V (2003) Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976) 28:2673–2678. doi:10.1097/01.BRS.0000099392.90849.AA

    Article  Google Scholar 

  6. Beaurain J, Bernard P, Dufour T, Fuentes JM, Hovorka I, Huppert J, Steib JP, Vital JM, Aubourg L, Vila T (2009) Intermediate clinical and radiological results of cervical TDR (Mobi-C) with up to 2 years of follow-up. Eur Spine J 18:841–850. doi:10.1007/s00586-009-1017-6

    Article  PubMed  CAS  Google Scholar 

  7. Ahn PG, Kim KN, Moon SW, Kim KS (2009) Changes in cervical range of motion and sagittal alignment in early and late phases after total disc replacement: radiographic follow-up exceeding 2 years. J Neurosurg Spine 11:688–695. doi:10.3171/2009.7.SPINE0946

    Article  PubMed  Google Scholar 

  8. Coric D, Nunley PD, Guyer RD, Musante D, Carmody CN, Gordon CR, Lauryssen C, Ohnmeiss DD, Boltes MO (2011) Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up: clinical article. J Neurosurg Spine 15:348–358. doi:10.3171/2011.5.SPINE10769

    Article  PubMed  Google Scholar 

  9. Schluessmann E, Aghayev E, Staub L, Moulin P, Zweig T, Roder C, SWISSspine (2010) SWISSspine: The case of a governmentally required HTA-registry for total disc arthroplasty. Results of cervical disc prostheses. Spine (Phila Pa 1976) 35(24):E1397–1405

  10. IEFO (2012) www.memdoc.org. University of Bern, Switzerland

  11. McAfee PC, Cunningham BW, Devine J, Williams E, Yu-Yahiro J (2003) Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech 16:384–389

    Article  PubMed  Google Scholar 

  12. Upadhyaya CD, Wu JC, Trost G, Haid RW, Traynelis VC, Tay B, Coric D, Mummaneni PV (2012) Analysis of the three United States Food and Drug Administration investigational device exemption cervical arthroplasty trials. J Neurosurg Spine 16:216–228. doi:10.3171/2011.6.SPINE10623

    Article  PubMed  Google Scholar 

  13. Coric D, Cassis J, Carew JD, Boltes MO (2010) Prospective study of cervical arthroplasty in 98 patients involved in 1 of 3 separate investigational device exemption studies from a single investigational site with a minimum 2-year follow-up. Clin article. J Neurosurg Spine 13:715–721. doi:10.3171/2010.5.SPINE09852

    Article  Google Scholar 

  14. Ren X, Wang W, Chu T, Wang J, Li C, Jiang T (2011) The intermediate clinical outcome and its limitations of Bryan cervical arthroplasty for treatment of cervical disc herniation. J Spinal Disord Tech 24:221–229. doi:10.1097/BSD.0b013e3181e9f309

    Article  PubMed  Google Scholar 

  15. Peng CW, Yue WM, Basit A, Guo CM, Tow BP, Chen JL, Nidu M, Yeo W, Tan SB (2011) Intermediate results of the prestige LP cervical disc replacement: clinical and radiological analysis with minimum two-year follow-up. Spine (Phila Pa 1976) 36:E105–E111. doi:10.1097/BRS.0b013e3181d76f99

    Article  Google Scholar 

  16. Goffin J, van Loon J, Van Calenbergh F, Lipscomb B (2010) A clinical analysis of 4- and 6-year follow-up results after cervical disc replacement surgery using the Bryan cervical disc prosthesis. J Neurosurg Spine 12:261–269. doi:10.3171/2009.9.SPINE09129

    Article  PubMed  Google Scholar 

  17. Quan GM, Vital JM, Hansen S, Pointillart V (2011) Eight-year clinical and radiological follow-up of the Bryan cervical disc arthroplasty. Spine (Phila Pa 1976) 36:639–646. doi:10.1097/BRS.0b013e3181dc9b51

    Article  Google Scholar 

  18. Chen J, Wang X, Bai W, Shen X, Yuan W (2012) Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis. Eur Spine J 21:674–680. doi:10.1007/s00586-011-2094-x

    Article  PubMed  Google Scholar 

  19. Mehren C, Suchomel P, Grochulla F, Barsa P, Sourkova P, Hradil J, Korge A, Mayer HM (2006) Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976) 31:2802–2806. doi:10.1097/01.brs.0000245852.70594.d5

    Article  Google Scholar 

  20. Leung C, Casey AT, Goffin J, Kehr P, Liebig K, Lind B, Logroscino C, Pointillart V (2005) Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery 57:759–763 (Discussion 759–763)

    Article  PubMed  Google Scholar 

  21. Lee JH, Jung TG, Kim HS, Jang JS, Lee SH (2010) Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement. Spine J 10:676–682. doi:10.1016/j.spinee.2010.04.017

    Article  PubMed  Google Scholar 

  22. Yi S, Kim KN, Yang MS, Yang JW, Kim H, Ha Y, do Yoon H, Shin HC (2010) Difference in occurrence of heterotopic ossification according to prosthesis type in the cervical artificial disc replacement. Spine (Phila Pa 1976) 35:1556–1561. doi:10.1097/BRS.0b013e3181c6526b

    Article  Google Scholar 

  23. Suchomel P, Jurak L, Benes V 3rd, Brabec R, Bradac O, Elgawhary S (2010) Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up. Eur Spine J 19:307–315. doi:10.1007/s00586-009-1259-3

    Article  PubMed  Google Scholar 

  24. Heidecke V, Burkert W, Brucke M, Rainov NG (2008) Intervertebral disc replacement for cervical degenerative disease—clinical results and functional outcome at two years in patients implanted with the Bryan cervical disc prosthesis. Acta neurochirurgica 150:453–459. doi:10.1007/s00701-008-1552-7 (Discussion 459)

    Article  PubMed  CAS  Google Scholar 

  25. Walraevens J, Demaerel P, Suetens P, Van Calenbergh F, van Loon J, Vander Sloten J, Goffin J (2010) Longitudinal prospective long-term radiographic follow-up after treatment of single-level cervical disk disease with the Bryan cervical disc. Neurosurgery 67:679–687. doi:10.1227/01.NEU.0000377039.89725.F3 (Discussion 687)

    Article  PubMed  Google Scholar 

  26. Kim HK, Kim MH, Cho DS, Kim SH (2009) Surgical outcome of cervical arthroplasty using bryan(r). J Korean Neurosurg Soc 46:532–537. doi:10.3340/jkns.2009.46.6.532

    Article  PubMed  Google Scholar 

  27. Wenger M, Hoonacker P, Zachee B, Lange R, Markwalder TM (2009) Bryan cervical disc prostheses: preservation of function over time. J Clin Neurosci 16:220–225. doi:10.1016/j.jocn.2008.01.021

    Article  PubMed  Google Scholar 

  28. Yu L, Song Y, Yang X, Lv C (2011) Systematic review and meta-analysis of randomized controlled trials: comparison of total disk replacement with anterior cervical decompression and fusion. Orthopedics 34:e651–e658. doi:10.3928/01477447-20110826-09

    PubMed  Google Scholar 

  29. Mummaneni PV, Robinson JC, Haid RW Jr (2007) Cervical arthroplasty with the Prestige LP cervical disc. Neurosurgery 60:310–314. doi:10.1227/01.NEU.0000255376.42099.13 (Discussion 314–315)

    Article  PubMed  Google Scholar 

  30. Murrey D, Janssen M, Delamarter R, Goldstein J, Zigler J, Tay B, Darden B (2009) Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 9:275–286. doi:10.1016/j.spinee.2008.05.006

    Article  PubMed  Google Scholar 

  31. Anderson PA, Sasso RC, Riew KD (2008) Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis. Spine (Phila Pa 1976) 33:1305–1312. doi:10.1097/BRS.0b013e31817329a1

    Article  Google Scholar 

  32. Jiang H, Zhu Z, Qiu Y, Qian B, Qiu X, Ji M (2012) Cervical disc arthroplasty versus fusion for single-level symptomatic cervical disc disease: a meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg 132:141–151. doi:10.1007/s00402-011-1401-7

    Article  PubMed  Google Scholar 

  33. Barrey C, Campana S, Persohn S, Perrin G, Skalli W (2012) Cervical disc prosthesis versus arthrodesis using one-level, hybrid and two-level constructs: an in vitro investigation. Eur Spine J 21:432–442. doi:10.1007/s00586-011-1974-4

    Article  PubMed  Google Scholar 

  34. Goffin J, Geusens E, Vantomme N, Quintens E, Waerzeggers Y, Depreitere B, Van Calenbergh F, van Loon J (2004) Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech 17:79–85

    Article  PubMed  Google Scholar 

  35. Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Jt Surg Am 81:519–528

    CAS  Google Scholar 

  36. Nunley PD, Jawahar A, Kerr EJ 3rd, Gordon CJ, Cavanaugh DA, Birdsong EM, Stocks M, Danielson G (2012) Factors affecting the incidence of symptomatic adjacent-level disease in cervical spine after total disc arthroplasty: 2- to 4-year follow-up of 3 prospective randomized trials. Spine (Phila Pa 1976) 37:445–451. doi:10.1097/BRS.0b013e31822174b3

    Article  Google Scholar 

  37. Yang B, Li H, Zhang T, He X, Xu S (2012) The incidence of adjacent segment degeneration after cervical disc arthroplasty (CDA): a meta analysis of randomized controlled trials. PLoS One 7:e35032. doi:10.1371/journal.pone.0035032

    Article  PubMed  CAS  Google Scholar 

  38. Aghayev E, Henning J, Munting E, Diel P, Moulin P, Roder C, Swissspine, Spine Tango Registry groups (2012) Comparative effectiveness research across two spine registries. Eur Spine J 21:1640–1647. doi:10.1007/s00586-012-2256-5

    Article  PubMed  Google Scholar 

  39. Aghayev E, Roder C, Zweig T, Etter C, Schwarzenbach O (2010) Benchmarking in the SWISSspine Registry: results of 52 dynardi lumbar total disc replacements compared with the data pool of 431 other lumbar disc prostheses. Eur Spine J 19(12):2190–2199. doi:10.1007/s00586-010-1550-3

    Google Scholar 

Download references

Acknowledgments

The authors are thankful to the SWISSspine registry group who made this research possible by populating the database with their valuable and much appreciated entries. Among others, the data of following colleagues were used in the study: Bärlocher C (n = 45), Sgier F (n = 40), Hasdemir M (n = 21), Etter C (n = 14), Markwalder T (n = 14), Favre J (n = 12), Ramadan A (n = 12), Wernli F (n = 12), Maestretti G (n = 10), Porchet F (n = 10), Baur M (n = 9), Cathrein P (n = 8), Hausmann O (n = 8), Grob D (n = 8), Otten P (n = 8), Tessitore E (n = 8), Heimberger K (n = 7), Bothmann M (n = 6), Ebeling U (n = 5), Scheufler KM (n = 5), Uehlinger K (n = 5), Aebi M (n = 4), Boos N (n = 4), Hamburger C (n = 4), Kast E (n = 4), Schaeren S (n = 4), Forster T (n = 3), Hora J (n = 3), Min K (n = 3), Morard M (n = 3), Moulin P (n = 3), Stoll TM (n = 3), Steinsiepe F (n = 3), Berlemann U (n = 2), Boscherini D (n = 2), Heini P (n = 2), Kraus U (n = 2), Marchesi D (n = 2), Martinez R (n = 2), Oberle J (n = 2), Renella R (n = 2), Schwarzenbach O (n = 2), Bartanusz V (n = 1), Binggeli R (n = 1), Bongioanni F (n = 1), Jeanneret B (n = 1), Kroeber M (n = 1), Schianchi P (n = 1). Funded by the AO Foundation start-up-grant S-10-41A.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Institute for Evaluative Research in Orthopedic Surgery, University of Bern, Stauffacherstrasse 78, 3014, Bern, Switzerland

    Emin Aghayev, Michal Neukamp & Christoph Röder

  2. Stephanshorn Hospital, Brauerstrasse 95, 9016, St. Gallen, Switzerland

    Christian Bärlocher

  3. St. Anna Clinic, St. Anna-Strasse 32, 6006, Luzern, Switzerland

    Friedrich Sgier & Oliver Hausmann

  4. Salem Hospital, Schänzlistrasse 39, 3000, Bern, Switzerland

    Mustafa Hasdemir & Frank Wernli

  5. Lindenhof Hospital, Bremgartenstrasse 119, 3001, Bern, Switzerland

    Klaus F. Steinsiepe & Uwe Ebeling

  6. Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland

    François Porchet

  7. Clinique La Colline, Avenue de Beau-Séjour 6, 1206, Genèva, Switzerland

    Aymen Ramadan

  8. Hôpital Cantonal de Fribourg, 1708, Fribourg, Switzerland

    Gianluca Maestretti

Authors
  1. Emin Aghayev
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian Bärlocher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Friedrich Sgier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mustafa Hasdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Klaus F. Steinsiepe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Frank Wernli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. François Porchet
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Oliver Hausmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Aymen Ramadan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gianluca Maestretti
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Uwe Ebeling
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Michal Neukamp
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Christoph Röder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emin Aghayev.

Additional information

On behalf of the SWISSspine Registry Group.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aghayev, E., Bärlocher, C., Sgier, F. et al. Five-year results of cervical disc prostheses in the SWISSspine registry. Eur Spine J 22, 1723–1730 (2013). https://doi.org/10.1007/s00586-013-2770-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-2770-0

Keywords

Search

Navigation